Significant gaps exist between the quality of health care being delivered and that which could be delivered to the U.S. population. Less is known about pediatric health services than about those for adults. Children with special health care needs (CSHCN) use significantly more health care resources than children without chronic conditions, putting them at higher risk for problems due to variations in health care quality and delivery. Very little health services research is currently supported in the Intermountain West, and virtually no projects are ongoing in children health services research. We propose to develop an infrastructure to generate and support a child health service research program for the Intermountain West. This effort will consist of 3 related activities: 1) Developing the Intermountain Consortium for Child Health Services Research through collaboration among seven organizations with significant resources and commitment to improving health care for children; 2) Implementing a Faculty Development Program to prepare and mentor faculty and others for careers in child health services research; and 3) Conduct a study comparing the impact of a pediatric hospitalist system with traditional care on outcomes for CSHCN admitted to Primary Children's Medical Center. The collaborators include: the Department of Pediatrics and Division of General Pediatrics of the University of Utah; Primary Children's Medical Center; Medicaid and the Bureau of CSHCN of the Utah Department of Health; the Utah Pediatric Practice-Based Research Network; and the Harvard Pediatric Health Services Research Fellowship Program. An integral component is the Child Health Services Research Laboratory, using student research assistants in a model developed by the PI. The long-term goal of the Intermountain Consortium is to establish a successful on-going collaborative child health services research program improving the quality and delivery of health care for all children in our region, with emphasis on CSHCN.